Parkwood Farms Therapy Center welcomes your support. Click `Support Us` to learn more about our needs.

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Summer Camp 2008 Application

Please complete the following registration form to reserve your spot in Summer Camp 2008.  You will need to complete a separate application for each camper.

(If you would rather apply by mail, click here to download a print application.)

Child's Name:
Parent's Name:
Street Address:
City, State, Zip:
Work Phone:
Cell Phone:
Home Phone:
Best time to reach you:
Email Address:
Camp Week
Select a first and second camp preference
First choice:
Second choice:
Options
Please select applicable options and preferences
Helmet rental ($15/week, $25 refundable deposit)
Payment Preferences
Please let us know how you plan to submit payment
 
 
Additional Details or Questions
Please describe your child's special needs here
 

On the next page, you will be able to review the submitted application and correct errors.

 

 
WELCOME | OUR HISTORY | NEWS & EVENTS | VOLUNTEERS
OUR ANGELS | SUPPORT US | CONTACT US
 

Parkwood Farms Therapy Center, Inc.
 A 501(C)(3) NON-PROFIT ORGANIZATION
2519 Parkwood Road ● Snellville GA 30039
678-344-6821 ● FAX 770-985-8758 ● info@parkwoodfarms.org
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